Summary

Research has been an essential component of nursing since the days of Florence Nightingale. It is codified into our practice acts and ethical standards and has evolved over the decades into a vibrant field of nursing researchers. Today every nurse should be able to use research, even when they are not conducting it themselves. With individuals or small groups, using research involves translating EBR into EBP through several steps that integrate the best scientific evidence with the nurse’s clinical experience and the patient’s values and needs. On larger scales, changes to implement EBP must be planned and negotiated with multiple stakeholders based as much on resources and institutional values as on the value of the research. Several models can facilitate these changes, including the JHEBP model.

Operationalizing EBP into EBDM involves the EBP triad of the patient’s preferences, the clinical expertise of the nurse, and the best available evidence. While effectively combining all three can be complicated, they have the greatest impact on patient outcomes. However, the nurse must also understand the available resources and limitations of their work setting and be able to develop alternatives when limitations prevent the first choice from being feasible. Clinical decision support tools such as bundles, checklists, and standardized processes have been developed to assist nurses and other healthcare workers in their decision-making. One type of tool, EBP bundles, has been shown to provide excellent results in acute care and ICU settings.

As with research and EBP, QI is integral to nursing care and should be performed continuously because care can always be improved. Because nurses directly care for patients and work on the “front lines” of health care, they are involved in all aspects and levels of QI; regardless of their role or specialty, all nurses engage in some QI activities. In addition to causing better patient outcomes, QI can promote innovation and professional development, decrease unnecessary tasks, and improve resource allocation. There are many organizations and initiatives that facilitate improvements to quality in health care, such as The Joint Commission, the Magnet Recognition Program, and the educational focus on QSENs.

Under their practice acts with individual states, nurses have the ability and responsibility to delegate certain tasks to other staff members. Nurses use the nursing standards of delegation to ensure the right task, circumstance, person, communication, and supervision for any tasks they delegate. They also use the principles of accountability, authority, and responsibility to ensure that tasks are performed appropriately while maintaining patient safety in all aspects.

Collaborative practice is a core standard for nurses and all healthcare professionals, who are expected to work in interprofessional teams that also include patients and their families. The importance of collaboration and teamwork is codified in our standards of practice, encouraged by national and international regulations, and taught in healthcare professional programs. High-functioning collaborative teams share common goals, mutual respect and support, and effective communication. Additionally, each member has clearly defined roles and aims to produce measurable outcomes. The IPEC core competencies for effective collaboration in health care are taught nationwide to ensure that all new healthcare professionals are skilled at collaborative practice.

The healthcare team consists of a wide array of team members with unique roles and responsibilities. Working together well must be a purposeful goal. Many professionals, from ministers to dietitians to respiratory therapists, may be important members of the healthcare team. A well-built team can lead to improved patient outcomes, higher-quality care, and greater likelihood that care plans will be fully implemented and adhered to. Setting clear goals, utilizing a curriculum for interprofessional training, and supporting leadership training with SMART goals and tools such as TeamSTEPPS 3.0 are a few strategies to create a strong, dynamic team of healthcare providers.